Is Influenza Vaccination Safe in Young Children?

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Summary and Comment

Is Influenza Vaccination Safe in Young Children?

A large population-based study of 6- to 23-month-old children found that it is.

Children younger than 2 years experience morbidity from influenza second only to that of the elderly. Thus, starting with the 2004–2005 winter season, guidelines have recommended that all children in the U.S. aged 6–23 months, rather than only those with chronic disease, receive the flu vaccine. The vaccine has been shown to be safe in small, population-based cohort studies; these investigators used a national vaccine registry to assess its safety on a larger scale.

More than 45,000 children received nearly 70,000 doses of trivalent inactivated influenza vaccine from 1991 to 2003 — before the universal recommendation was implemented. Medical events occurring during various intervals from 1 to 42 days after vaccination were compared with those occurring 15 or more days prior to vaccination (to control for the fact that only children who were healthy in the 14 days prior to a well-child visit would likely receive vaccine). Medical events were assessed by chart review for possible causation by the vaccine.

No serious medical events were found to be more common during any of the periods assessed. In particular, risk for febrile seizure was not increased. Several conditions were found to be significantly less common after vaccination, including upper respiratory tract infection, asthma, bronchiolitis, and otitis media.

Comment: These results should offer reassurance about the safety of trivalent inactivated influenza vaccine in toddlers. The findings also provide some indirect evidence of benefit in the 6 weeks following vaccination.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine October 26, 2006